Abstract
The costly nature of health sector responses to humanitarian crises and resource constraints means that there is a need to identify methods for priority setting and long-term planning. One method is economic evaluation. The aim of this systematic review is to examine the use of economic evaluations in health-related humanitarian programmes in low- and middle-income countries. This review used peer-reviewed literature published between January 1980 and June 2018 extracted from four main electronic bibliographic databases. The eligibility criteria were full economic evaluations (which compare the costs and outcomes of at least two interventions and provide information on efficiency) of health-related services in humanitarian crises in low- and middle-countries. The quality of eligible studies is appraised using the modified 36-question Drummond checklist. From a total of 8127 total studies, 11 full economic evaluations were identified. All economic evaluations were cost-effectiveness analyses. Three of the 11 studies used a provider perspective, 2 studies used a healthcare system perspective, 3 studies used a societal perspective and 3 studies did not specify the perspective used. The lower quality studies failed to provide 7information on the unit of costs and did not justify the time horizon of costs and discount rates, or conduct a sensitivity analysis. There was limited geographic range of the studies, with 9 of the 11 studies conducted in Africa. Recommendations include greater use of economic evaluation methods and data to enhance the microeconomic understanding of health interventions in humanitarian settings to support greater efficiency and transparency and to strengthen capacity by recruiting economists and providing training in economic methods to humanitarian agencies.
Highlights
Humanitarian crises include complex emergencies such as armed conflict, famines, major epidemic outbreaks and natural disasters such as earthquakes
The search strategy consisted of search terms related to: (1) humanitarian crises, (2) low- and middleincome countries (LMICs), (3) public health interventions and (4) economic evaluations
The National Health Service (NHS) Economic Evaluation Database (EED) search strategy contained search terms related to quality-adjusted life years (QALYs), whereas disabilityadjusted life years (DALYs) are more often used in LMIC settings; search terms related to DALYs were incorporated into the search strategy (Glanville et al, 2009)
Summary
Humanitarian crises include complex emergencies such as armed conflict, famines, major epidemic outbreaks and natural disasters such as earthquakes. The health challenges faced by crisis-affected populations, including refugees and internally displaced persons, include high mortality and morbidity rates due to communicable diseases, malnutrition, non-communicable diseases (NCDs), poor mental health and poor reproductive and sexual health. It was estimated that 201 million individuals needed humanitarian protection.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
